Individual
DR. DANIEL R. WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11188 TESSON FERRY RD STE 202, SAINT LOUIS, MO 63123-6962
(314) 729-7547
(314) 729-7547
Mailing address
11888 TESSON FERRY RD., STE. 202, ST. LOUIS, MO 63123
(314) 729-7547
(314) 729-7550
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
129759
NY
2084N0400X
Neurology Physician
Primary
2007009239
MO
Other
Enumeration date
05/26/2006
Last updated
09/21/2021
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